The association between nonmedical use of prescription medication status and change in health-related quality of life: results from a Nationally Representative Survey.

Abstract

Nonmedical use of prescription medication (NUPM) is associated cross-sectionally with a host of medical and psychosocial consequences. Few studies, however, have examined longitudinal outcomes based on NUPM indicators. This study aimed to address this gap by examining change in health-related quality of life as a function of NUPM status. Data are from waves 1 and 2 of the National Epidemiological Survey on Alcoholism and Related Conditions (NESARC) a household-based, nationally-representative survey of the US population. 34,653 participants who completed both NESARC waves were included in analyses. The primary outcome measure was the 12-item Short Form Health Survey (SF-12), with history of NUPM of opioids, tranquilizer/sedatives and stimulants (examined separately) at wave 1 and any NUPM between waves 1 and 2 used to group participants. Sociodemographic characteristics were used as control variables. Across medication classes, results indicated that individuals who initiated NUPM between waves (initiators) had greater declines or smaller increases on many SF-12 scales, when compared to other groups. Individuals with a history of NUPM at wave 1 but no use between waves (quitters) and never users generally had the best outcomes in terms of change in SF-12 scales, with quitters making larger gains (or smaller losses) in mental health-related quality of life. Persistent users were generally intermediate between initiators and quitters or never users. These data reinforce the importance of preventing NUPM initiation and of promoting NUPM cessation, highlighting the need for greater use of NUPM-related public health interventions.